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What is molluscum contagiosum? Molluscum contagiosum is an infection caused by a poxvirus. The result of the infection is usually a benign, mild skin disease characterized by lesions that may appear anywhere on the body. Molluscum contagiosum is a self-limited infection, which means it resolves by itself. The lesions are small, raised, and usually white, pink, or flesh-colored with a dimple or a pit in the center. It has a pearly appearance and is smooth and firm. In most people, the lesions range from about the size of a pinhead to as large as a pencil eraser, which is two to five millimeters in diameter. Mollusca may occur anywhere on the body, including the face, neck, arms, legs, abdomen, and genital area, alone or in groups. The lesions are rarely found on the palms of the hands or the soles of the feet. So, who's at risk for molluscum contagiosum? Most commonly, children between the ages of one to 10, but it's not limited to just children. People are at increased risk for getting the disease if they have a weakened immune system, like from HIV infection or if they're being treated for cancer. Their growths may look a little different. They could be larger and more difficult to treat. They may have atopic dermatitis. This is a risk factor for getting molluscum contagiosum due to frequent breaks in the skin. People with this condition also may be more likely to spread molluscum contagiosum to other parts of their body for the same reason. And lastly, people who live in a warm, humid climate where living conditions are crowded. So, how is it transmitted? It's transmitted primarily direct person-to-person and through physical contact, contaminated fomites, inanimate objects that can become contaminated with virus such as clothing and towels, bathing sponges, pool equipment, and toys, sexual contact, shaving and electrolysis. Molluscum can be spread to other parts of their body by touching or scratching a lesion and then touching their body somewhere else. This is called autoinoculation. The virus remains in the top layer of the skin, called the epidermis, and does not circulate throughout the body. Once the lesions are gone, the virus is gone and you cannot spread it to others. What is the incubation period for molluscum contagiosum? This is between two weeks a six months, and the signs and symptoms include small pearly papules with a central depression whose core may be expressed, producing a white cheesy material. The lesions average two to five millimeters in size. It's usually painless, but may become inflamed, red, and swollen. The papules usually disappear spontaneously within six to 12 months but may take as long as four years to resolve. Most cases occur in children over one year of age, with only one known case reported in an infant at seven days post-partum. Molluscum contagiosum diagnosis. Diagnosis is made on the appearance. Molluscum contagiosum lesions have recently come to be classified in one of three ways. One, the commonly seen skin lesions found largely on the faces, trunks, and limbs of children. Two, the sexually transmitted lesions found on the abdomen, inner thighs, and genitals of sexually active adults. And three, the diffuse and recalcitrant eruptions of patients with AIDS or other immunosuppressive disorders. The period of communicability is unknown but probably as long as the lesions are persistent. How do we treat molluscum contagiosum? Because molluscum contagiosum is self-limited in healthy individuals, treatment may be unnecessary. Issues such as lesion visibility, underlying atopic disease, and the desire to prevent transmission may prompt therapy. Treatment is usually recommended if lesions are in the genital area, on or near the penis, vulva, vagina, or anus. Treatment options. Physical removal requires a trained healthcare provider and may require a local anesthesia, and can result in post-procedural pain, irritation, and scarring, cryotherapy, curettage, laser therapy, and oral therapy. Another is oral cimetidine and it's been used as an alternative treatment for small children who are either afraid of the pain associated with cryotherapy, curettage, and laser therapy or because the possibility of scarring is to be avoided. Facial mollusca do not respond as well as lesions elsewhere on the body. How do we prevent it? The best way to avoid getting molluscum is by following good hygiene habits. Remember that the virus lives only in the skin and once the lesions are gone, the virus is gone and you cannot spread the virus to others, so remember to wash your hands. Keeping your hands clean is the best way to avoid molluscum infection as well as many other infections. Hand washing removes germs that may have been picked up from other people or from surfaces that have germs on them. Don't scratch or pick at molluscum lesions. It's important not to touch, pick, or scratch skin that has any lesions at all. Not only your own, but others as well. Picking and scratching can spread the virus to other parts of the body and makes it easier to spread the disease to other people, too. Keep molluscum lesions covered. It's important to keep the area with molluscum lesions clean and covered with clothing or a bandage so that others do not touch the lesion and become infected. Do remember to keep the affected skin clean and dry. In preventing molluscum contagiosum, be careful during sports activities. Don't share towels, clothing, or other personal items. People with molluscum should not take part in contact sports like wrestling, basketball, and football unless all lesions can be covered by clothing or bandages. Activities that use shared gear like helmets, baseball gloves, and balls should also be avoided unless all lesions can be covered. Swimming should also be avoided unless all lesions can be covered by watertight bandages. Personal items such as towels, goggles, and swim suits should not be shared. Other ways to avoid sharing your infection. Do not shave or have electrolysis on areas with lesions. Don't share personal items, such as unwashed clothes, hair brushes, wrist watches, and bar soap with others. And if you have lesions on or near the penis, vulva, vagina, or anus, avoid sexual activities until you see a healthcare provider.
In this lesson, we'll be diving into molluscum contagiosum, a condition most of you are probably not familiar with in the slightest. We'll predictability provide information on what it is, who's most at risk, how it's transmitted, the signs and symptoms, how it's diagnosed, as well as treatment options and prevention strategies.
Molluscum is an infection caused by a poxvirus (molluscum contagiosum virus) that usually results in a benign, mild skin disease with lesions that can appear anywhere on the body. The good news is that molluscum is self-resolving, which means it typically goes away on its own.
Lesions are small, raised, and usually white, pink, or flesh colored. They have a dimple or pit in the center, are smooth and firm, and can range in size from 2-5mm, or about the size of a pinhead to the size of a pencil eraser.
Mollusca can appear alone or in groups and can occur anywhere on the body, including the face, neck, arms, legs, abdomen, and genitals. However, they are rarely found on the palms and soles of the feet.
Who is Most at Risk?
Molluscum is most common in, but not limited to, children between the ages of one and 10 years of age. People with weakened immune systems (HIV, cancer) are also at risk, and the growths for these individuals may be larger and more difficult to treat.
People with atopic dermatitis are also at risk, due to breaks in the skin, as are people who live in warm, humid climates with crowded living conditions.
How is Molluscum Transmitted?
There are a few ways that molluscum is transmitted including:
- Person to person contact, including sexual contact
- By touching contaminated objects
- Shaving and electrolysis
Pro Tip #1: Molluscum is easily spread to other areas of the body by touching or scratching lesions then touching somewhere else, which is known as autoinoculation.
The virus remains on the top layer of skin (epidermis) and does not circulate throughout the body. Once lesions are gone, so too is the virus. And when that happens, it cannot be spread to others.
The incubation period for molluscum is from two weeks to six months.
Signs and Symptoms of Molluscum
Molluscum appears as a small, pearly-white bump on the skin with a central depression, possibly secreting a white cheesy substance. Lesions are between 2-5mm, usually painless and may become inflamed, red, and swollen.
These bumps will usually disappear spontaneously within six to 12 months but could linger for up to four years. Most cases involve children over the age of one, and there is only one known case of an infant becoming infected.
How is Molluscum Diagnosed?
Lesions are classified in one of three ways:
- Lesions that are found on the face, trunk, and limbs of a child.
- Sexually transmitted lesions on the abdomen, inner thighs, and genitals of sexually active adults.
- Diffuse, recalcitrant eruptions on people with AIDS and other immunosuppressive disorders.
The period of communicability is unknown but likely lasts as long as lesions persist.
Molluscum Treatment Options
Because molluscum is self-limiting in healthy people, treatment is usually not necessary. However, issues such as lesion visibility, underlying atopic diseases, and the desire to prevent transmission may prompt treatment. And treatment is usually recommended if lesions are in the genital area.
Treatment consists of medications or physical removal by the following means:
- Cryotherapy – freezing with liquid nitrogen
- Cutting, scraping, or scooping
- Laser therapy
Pro Tip #2: Under the heading of don't try this at home, physical removal requires a trained healthcare provider. Anesthesia may be required, and removal can result in pain, irritation, and scarring.
Oral cimetidine (medication) is an alternative treatment for small children who are afraid of the pain associated with removal or because of the avoidance of scarring. It should be noted that facial Mollusca don't respond as well to this treatment as do lesions elsewhere on the body.
Prevention of Molluscum
The best way to prevent molluscum is to follow good hygiene habits. The virus only lives on the skin. Once lesions are gone, the virus is gone and cannot be spread to others.
Handwashing is the best line of defense, as it removes the germs that may have been picked up from other people or surfaces with germs on them.
Pro Tip #3: Do not touch, scratch, or pick at lesions. Doing so can spread the virus to other parts of the body and other people who come in contact with you. It's also important to keep lesions clean and covered at all times, and it's a good idea to keep them dry as well.
Be especially careful during sporting activities, like taking part in contact sports like football, wrestling, and basketball. And don't share equipment like towels, clothing, swimsuits, baseball gloves, helmets, and personal items like hairbrushes, wrist watches, and bar soap if you have an infection.
If you have lesions around the genitals – penis, vulva, vagina, and anus – avoid sexual contact until after seeing a healthcare provider.